Device for offloading capped vials useful in system and method for dispensing prescriptions

ABSTRACT

An offloading unit for an automated pharmaceutical machine that dispenses filled, capped pharmaceutical vials includes at least one offload location; at least one tote to receive the vials at each offload location, the tote assigned for distribution to a remote pharmacy location; at least one sensor to detect the presence or absence of the tote; and at least one sensor to detect a fill level of the vials in the tote.

RELATED APPLICATIONS

The present application claims the benefit of and priority from U.S.Provisional Patent Application Nos. 61/692,442, filed Aug. 23, 2012,61/813,431, filed Apr. 18, 2013, and 61/834,198, filed Jun. 12, 2013,the disclosure of each of which is hereby incorporated herein in itsentirety.

FIELD OF THE INVENTION

The present invention is directed generally to the dispensing ofprescriptions of pharmaceuticals, and more specifically is directed tothe automated dispensing of pharmaceuticals.

BACKGROUND OF THE INVENTION

Pharmacy generally began with the compounding of medicines whichentailed the actual mixing and preparing of medications. Heretofore,pharmacy has been, to a great extent, a profession of dispensing, thatis, the pouring, counting, and labeling of a prescription, andsubsequently transferring the dispensed medication to the patient.Because of the repetitiveness of many of the pharmacist's tasks,automation of these tasks has been desirable.

Some attempts have been made to automate the pharmacy environment.Different exemplary approaches are shown in U.S. Pat. No. 5,337,919 toSpaulding et al. and U.S. Pat. Nos. 6,006,946; 6,036,812 and 6,176,392to Williams et al. The Williams system conveys a bin with tablets to acounter and a vial to the counter. The counter dispenses tablets to thevial. Once the tablets have been dispensed, the system returns the binto its original location and conveys the vial to an output device.Tablets may be counted and dispensed with any number of countingdevices. Drawbacks to these systems typically include the relatively lowspeed at which prescriptions are filled and the absence in these systemsof securing a closure (i.e., a lid) on the container after it is filled.

One additional automated system for dispensing pharmaceuticals isdescribed in some detail in U.S. Pat. No. 6,971,541 to Williams et al.This system has the capacity to select an appropriate vial, label thevial, fill the vial with a desired quantity of a selected pharmaceuticaltablet, apply a cap to the filled vial, and convey the labeled, filled,capped vial to an offloading station for retrieval.

Although this particular system can provide automated pharmaceuticaldispensing, certain of the operations may be improved. For example, theoffload station of the system comprises a series of stationary holdingcompartments of conventional configuration. It may be desirable toprovide an offload station having a different configuration that canimprove speed and reliability of the system and allow for versatility ofprescription filling options for the pharmacy.

SUMMARY OF THE INVENTION

As a first aspect, embodiments of the present invention are directed toan offloading unit for an automated pharmaceutical machine thatdispenses filled, capped pharmaceutical vials, comprising: at least oneoffload location; at least one tote to receive the vials at each offloadlocation, the tote assigned for distribution to a remote pharmacylocation; at least one sensor to detect the presence or absence of thetote; and at least one sensor to detect a fill level of the vials in thetote.

As a second aspect, embodiments of the present invention are directed toa pharmaceutical dispensing system, comprising: a frame; a plurality ofcells configured to house pharmaceutical pills; a processor; memorycoupled to the processor; and a computer program residing in the memorythat is executable by the processor for transmitting a message to one ormore pre-identified locations about a status or function of the system.

As a third aspect, embodiments of the present invention are directed toa pharmaceutical dispensing system, comprising: a frame; a plurality ofcells configured to house pharmaceutical pills; a processor; memorycoupled to the processor; at least one offload location; at least onetote to receive the vials at each offload location, the tote assignedfor distribution to a remote pharmacy location; at least one sensor todetect the presence or absence of the tote; at least one sensor todetect a fill level of the vials in the tote; and a GUI, wherein the GUIincludes a portion specific to filling of the at least one tote.

BRIEF DESCRIPTION OF THE FIGURES

FIG. 1 is a flow chart of operations according to embodiments of thepresent invention.

FIG. 2 is a top, front perspective view of a pharmaceutical dispensingsystem according to embodiments of the present invention.

FIG. 3 is a top, rear perspective view of the system of FIG. 2 with theouter panel of the system removed to show the internal components.

FIG. 4 is an isometric view of an offload chute unit according to thepresent invention.

FIG. 5 is a side view of the chute unit of FIG. 4.

FIG. 6 is a top view of the chute unit of FIG. 4.

FIGS. 7-10 are sequence views of a vial traveling through the chute unitof FIG. 4, the chute unit being shown in side section view.

FIG. 11 is a side section view of the chute unit of FIG. 4 illustratingthat the trough thereof can hold two vials at once.

FIG. 12 is a top view of the chute unit of FIG. 4 illustrating that thechutes can hold vials of different sizes.

FIG. 13 is an enlarged side section view illustrating a reversibleclosure (RC) vial entering the chute unit of FIG. 4.

FIG. 14 is a Home screen of the system graphical user interface.

FIG. 15 is a Tote View screen of the tote offload portion of the systemgraphical user interface.

FIG. 16 is an In-Store screen of the system graphical user interface.

FIG. 17 is a schematic diagram of a “hub-and-spoke” configuration forpharmaceutical distribution that incorporates a pharmaceuticaldispensing system similar to that of FIGS. 1-12 serving as the “hub”.

FIG. 18 is a rear perspective view of the system of FIG. 2 showing theaddition of chutes and totes for offloading of vials.

FIG. 19 is a front perspective view of the system of FIG. 2 showing theaddition of a chute and an automatic bagging and printing unit, with atote for offloading of vials.

FIG. 20 is a partial perspective view of the system of FIG. 3 with somesubsystems removed to show an exemplary imaging subsystem.

FIG. 21 is a flow chart illustrating exemplary operation of the systemfor filling of prescriptions in a “hub and spoke” arrangement.

DETAILED DESCRIPTION OF EMBODIMENTS OF THE INVENTION

The present invention will now be described more fully hereinafter, inwhich preferred embodiments of the invention are shown. This inventionmay, however, be embodied in different forms and should not be construedas limited to the embodiments set forth herein. Rather, theseembodiments are provided so that this disclosure will be thorough andcomplete, and will fully convey the scope of the invention to thoseskilled in the art. In the drawings, like numbers refer to like elementsthroughout. Thicknesses and dimensions of some components may beexaggerated for clarity.

Unless otherwise defined, all terms (including technical and scientificterms) used herein have the same meaning as commonly understood by oneof ordinary skill in the art to which this invention belongs. It will befurther understood that terms, such as those defined in commonly useddictionaries, should be interpreted as having a meaning that isconsistent with their meaning in the context of the relevant art andwill not be interpreted in an idealized or overly formal sense unlessexpressly so defined herein.

The terminology used herein is for the purpose of describing particularembodiments only and is not intended to be limiting of the invention. Asused herein, the singular forms “a”, “an” and “the” are intended toinclude the plural forms as well, unless the context clearly indicatesotherwise. It will be further understood that the terms “comprises”and/or “comprising,” when used in this specification, specify thepresence of stated features, integers, steps, operations, elements,and/or components, but do not preclude the presence or addition of oneor more other features, integers, steps, operations, elements,components, and/or groups thereof. As used herein the expression“and/or” includes any and all combinations of one or more of theassociated listed items.

In addition, spatially relative terms, such as “under”, “below”,“lower”, “over”, “upper” and the like, may be used herein for ease ofdescription to describe one element or feature's relationship to anotherelement(s) or feature(s) as illustrated in the figures. It will beunderstood that the spatially relative terms are intended to encompassdifferent orientations of the device in use or operation in addition tothe orientation depicted in the figures. For example, if the device inthe figures is turned over, elements described as “under” or “beneath”other elements or features would then be oriented “over” the otherelements or features. Thus, the exemplary term “under” can encompassboth an orientation of over and under. The device may be otherwiseoriented (rotated 90 degrees or at other orientations) and the spatiallyrelative descriptors used herein interpreted accordingly.

Well-known functions or constructions may not be described in detail forbrevity and/or clarity.

As described above, the invention relates generally to a system andprocess for dispensing pharmaceuticals. An exemplary process isdescribed generally with reference to FIG. 1. The process begins withthe identification of the proper container, tablets or capsules andclosure to be dispensed based on a patient's prescription information(Box 20). A container of the proper size is dispensed at a containerdispensing station (Box 22), then grasped and moved to a labelingstation (Box 24). The labeling station applies a label to the container(Box 26), after which the container is transferred to a tabletdispensing station (Box 28), from which the designated tablets aredispensed in the designated amount into the container (Box 30). Thefilled container is then moved to a closure dispensing station (Box 32),where a closure of the proper size has been dispensed (Box 34). Thefilled container is secured with a closure (Box 36), then transported toan offload station and offloaded (Box 38).

A system that can carry out this process is illustrated in FIGS. 2 and 3and designated broadly therein at 40. The system 40 includes a supportframe 44 for the mounting of its various components. The system 40generally includes as operative stations a controller (representedherein by a graphics user interface monitor 42), a container dispensingstation 58, a labeling station 60, a tablet dispensing station 62, aclosure station 64, and an offloading station 66. In the illustratedembodiment, containers, tablets and closures are moved between thesestations with a single carrier 68; however, in some embodiments only asingle carrier may be employed, or one or more additional carriers maybe employed. The operation of the container dispensing station 58, thelabeling station 60, the tablet dispensing station 62, and the closurestation 64 are described in, for example, U.S. Patent ApplicationPublication Nos. 2008/0110921 and 2008/0110555; and U.S. Pat. Nos.7,596,932; and 7,344,049, the disclosures of each of which are herebyincorporated herein in its entirety. Additional components and featuresof the system are described in U.S. Patent Application Publication Nos.2008/0283179 and 2009/0179041, and U.S. Pat. No. 8,113,492, U.S. Pat.No. 8,224,482, and U.S. Pat. No. 8,244,398, the disclosures of each ofwhich are hereby incorporated herein in its entirety.

During the prescription filling process, a pharmacist typically mustview the contents of the vial to verify that the prescription has beenfilled correctly. When the vial is filled in an automated system thatincludes a closure station 64, such as the system 40, the pharmacistmust remove the cap on the vial to perform this verification. In someembodiments of the invention, the system 40 may include a camera 72positioned such that it may capture an image of the contents of the vialprior to the vial being moved to the closure station 64 for capping. Asshown in FIG. 20, the camera 72 may be located, for example, above anexception assembly 70 (for offloading of vials that encounter a problemin the filling process), but may be located in any other location whereit will not interfere with other operations of the system 40. Once thepills have been dispensed into the vial, the carrier 68 may move thefilled vial to a position, on a shelf 74, for example, near the camera72 so that an image of the contents of the vial may be captured prior tocapping the vial. In the illustrated embodiment, the camera 72 issituated so as to view and capture an image from the top of the vial. Insome embodiments, the camera 72 and associated lighting system may besituated so as to capture the image of the pills through the vial, inwhich case the imaging step may occur before or after the capping step.Exemplary apparatus and methods for imaging the prescription through thevial can be found in U.S. Pat. No. 7,889,330; U.S. Pat. No. 8,284,305;U.S. Pat. No. 8,345,989; and U.S. Pat. No. 8,477,989, the disclosures ofwhich are hereby incorporated by reference herein in their entirety.Images may be stored in the system 40 or at another location accessibleto the system 40. The pharmacist may verify that the vial contains thecorrect drug by viewing the image of the contents of the vial. Thepharmacist may view the image of the vial contents at a location that isproximate to the system 40 or in a remote location. Alternatively,automated image analysis may be employed to automatically verify theidentity of the dispensed pharmaceutical and determine whether itmatches the prescription that was requested. An exemplary image analysissystem is described in U.S. Pat. No. 6,535,637, the disclosure of whichis hereby incorporated by reference herein in its entirety. The system40 may then report whether each prescription has passed the verificationstep; any vial that cannot be automatically verified may be flagged formanual verification by the pharmacist or for verification by some otherprocess.

In another embodiment, a scale or other implementation of a weightsensor may be used in an additional verification process for the fillingof the prescription. Exemplary systems employing a weight sensor toweigh the contents of a medication container are described in U.S. Pat.Nos. 8,108,068 and 5,337,919, the disclosure of each of which is herebyincorporated by reference herein in its entirety. The scale may beotherwise incorporated into the system 40, including a stand-alone scale78 (FIG. 3) on which the filled vial is deposited so that the weight maybe determined. The scale 78 may be positioned in a location that islevel and not subject to a significant amount of vibratory interferencefrom other parts of the system 40. The scale 78 may be located on theshelf 74 (FIG. 20) upon which vials are placed for imaging; in thisposition, weighing and image capture can occur simultaneously, ifdesirable to do so. By comparing the total weight of the prescriptionvial and its contents with the expected weight of the filledprescription, the controller may provide another indication as towhether the prescription has been filled correctly. If the total weightof the vial and its contents does not match the expected weight of thefilled prescription, the controller may direct steps to remedy thesituation. For example, the controller may direct the carrier 68 toreturn the vial to the appropriate location in the tablet dispensingstation 62 so that missing pills can be added, if the controllerdetermines that the vial may be missing one or more pills because theweight of the vial and its contents is lower than expected. Thecontroller may flag the vial with an error message indicating that theactual weight does not match the expected weight, so that pharmacy staffcan investigate to determine if any errors had occurred in the fillingprocess.

Turning now to FIG. 3, the offload station 66 includes a number of chuteunits 100, each of which, in the illustrated embodiment, includes twochutes 102, 104, although those skilled in this art will appreciate thata chute unit may include only a single chute or may include more thantwo chutes. Also, the offload station 66 may include only a single chuteunit or any appropriate number of chute units.

The chutes 102, 104 are substantially identical mirror images of eachother about a vertical plane P (see FIG. 4). As such, only the chute 102will be described in detail herein, with the understanding that thedescription is equally applicable to the chute 104. For the purpose ofthis discussion, the terms “front,” “forward” and derivatives thereofrefer to the direction that a pharmaceutical vial travels in the chute102, i.e., from right to left from the vantage point of FIG. 4. Theterms “rear”, “back” and derivatives thereof refer to the direction thatis opposite of the “forward” direction, i.e., from left to right fromthe vantage point of FIG. 4. One may also think of the forward directionas extending “downstream” in the chutes 102, 104 and the rearwarddirection as extending “upstream” in the chutes 102, 104.

Referring again to FIG. 4 and also to FIGS. 5 and 6, the chute 102 has arear lip 106 that resides above the frame 44. The lip 106 includes ashallow arc such that it is slightly concave. The lip 106 mergessmoothly at its front end with a concave ramp 110. Side walls 108, 109rise from the lateral edges of the ramp 110, with the forward ends ofthe side walls 108, 109 being higher than the rearward ends. The effectof the configuration provided by the lip 106, the ramp 110 and the sidewalls 108, 109 is that of a half-bowl that drains downwardly into theremainder of the chute 102. The lower portion of the ramp 110 rests onthe frame 44.

Still referring to FIGS. 4-6, a trough 112 having an arcuate profileextends forwardly and downwardly from the front end of the ramp 110. Thetrough 112 includes a concave floor 113 that is bounded at its lateraledges by dividers 116, 117. A rear wall 114 rises above the rear end ofthe trough 112; the bottom portion 114 a of the rear wall 114 anglesrearwardly and has an arcuate lower edge 114 b that, in combination withthe rear end of the floor 113, forms an inlet 115 (see FIG. 7). At theirrearward ends, the dividers 116, 117 are similar in height to the rearwall 114. Each of the dividers 116, 117 has a leading edge 118 thatslopes sharply downward in a central portion of the divider 116, 117,such that the forward portion of the divider 116, 117 is relatively low.A front wall 120 spans the front ends of the troughs 112 and provides alanding area for vials. The front wall 120 may have a foam or othershock absorbent material attached thereto to reduce any rebound effectof the vial dropping down the chute 102 and striking the front wall 120.

The chute unit 100 is attached to the frame 44 via four latches 122. Thelatches 122 are inserted into mating apertures (not shown) in the frame44. In the illustrated embodiment, the chute unit 100 is mounted so thatthe troughs 112 slope downwardly from back to front; for example, thechute unit 100 may be mounted such that the trough 112 is angledrelative to a horizontal plane at an angle of between about 20 and 35degrees.

In the illustrated embodiment, the chute unit 100 is formed as a unitarymember, although those skilled in this art will appreciate that thechute unit may be formed with multiple components. The chute unit 100may be formed of any material recognized as being suitable for theconveying of objects such as pharmaceutical vials; exemplary materialsinclude polymeric materials such as polycarbonate, ABS and copolymersand blends thereof.

Referring now to FIGS. 7-10, in operation, after a vial V has beendispensed, labeled, filled and capped, it is transported by the carrierto the offload station 66. The carrier 70 deposits the vial V“right-side up” into the half-bowl formed by the lip 106, the side walls108, 109, and the ramp 110 (see FIG. 7); the angled bottom portion 114 aof the rear wall 114 can also assist in funneling the vial V intoposition. In some embodiments, the dimensions of the lip 106, ramp 110,side walls 108, 109 and bottom portion 114 a of the rear wall 114 areselected to ensure that a “right side up” vial V presented by thecarrier 70 exits the “half-bowl” with the lower (i.e., non-capped) endleading the upper, capped end, irrespective of which of multiple commonvial sizes is presented (see FIG. 8). Typically, the length of a cappedvial V is between about 2 and 4 inches, and the diameter is betweenabout 1.25 and 2.0 inches. In some embodiments, the distance between theside walls 108, 109 is between about 2.5 and 2.75 inches, the ramp 110has a depth of about 1.5 to 2.0 inches, the distance from the rear edgeof the ramp 110 to the rear edge of the bottom portion 114 a of the rearwall 114 is between about 3.25 and 3.5 inches, and the ramp 110generally forms an angle of between about 20 and 30 degrees relative toan underlying horizontal surface.

Also, the smoothly merging side walls 108, 109, lip 106 and ramp 110 areconfigured such that vials do not snag or hang thereon. In particular,vials known as “RC” vials (available from Owens-Corning, Owens, Ill.),have a finger on the edge thereof that might be susceptible to beingcaught on an unsmooth surface (see FIG. 13).

Once the vial V enters the half-bowl formed by the ramp 110, the sidewalls 108, 109 and the lip 106, the vial V, oriented “non-capped enddown”, slides through the inlet 115 (see FIG. 9) and down the trough 112to the front wall 116 (see FIG. 10), where it rests until pharmacypersonnel remove it. In some embodiments, it may be desirable for atleast two vials V1, V2 to be stored at once in the trough in a stackedarrangement (see FIG. 11). As such, the trough 112 may have a length ofbetween about 9 and 10 inches, which enables two vials 4 inches inlength to be stored and accessible for pharmacy personnel. Also, vialsof different sizes can be stored in chutes 102, 104 (see FIG. 12).

Also, the dividers 116, 117 may be configured such that the chute unit100 satisfies the provisions of UL 61010A-1, 1740 (the requirements ofwhich are hereby incorporated herein by reference), which requires thatan object 2.95 in diameter be prevented from entering the inlet 115(this test is intended to simulate a human hand entering the inlet 115from outside of the system). In some embodiments, the leading edges 118of the dividers 116, 117 are positioned between about 5 and 7 inchesfrom the inlet 115 and are between about 2.5 and 2.75 inches apart.

In another embodiment, instead of being deposited into the chutes of theoffload station 66, the carrier 68 may deliver a filled and capped vialto another location where a tote 61 (FIG. 18), for example, with thecapacity to hold many vials simultaneously, is positioned. Such alocation may alternatively consist of a box, bin, or other container ofappropriate capacity. The tote's contents may be designated for deliveryto a pharmacy location different from that where the system 40 islocated. Multiple totes 61 may be used with the system 40simultaneously; in some embodiments each tote 61 may be allocated to adifferent pharmacy such that the system 40 is filling prescriptions formultiple pharmacies in a “hub and spoke” type of an arrangement, such asthat shown in FIG. 17. The hub-and-spoke arrangement 300 includes apharmacy where a system 40 is located as the “hub” 302 and a number ofremote pharmacies 304. Prescription orders from the remote pharmacies304 are received by the hub 302, filled, and subsequently delivered tothe remote pharmacies 304 with the communication and delivery pathsbetween the hub 302 and remote pharmacies 304 considered the “spokes”306. As prescriptions are processed through the system 40, thecontroller 42 may, based on the ultimate disposition of eachprescription, designate the proper location for offload of each vialfrom the system 40. Totes 61 may be located in any area of the system 40that is amenable to such placement. An exemplary location for a tote 61is the shelf area 65 shown at the end of the system 40 in FIGS. 2 and 3.This may be a desirable location for a tote 61 due to, among otherreasons, its proximity to the closure station 64; as closures areapplied to filled vials, the carrier 68 would have a shorter distance totravel to drop off the vial. The tote 61 may rest on a shelf, which maybe attached to the system 40 or free standing, or the tote 61 may bedirectly attached to the system 40; the attachment mechanism may bereversible so that the entire tote 61 can be removed for furtherprocessing and/or delivery of the contents of the tote 61. Additionally,multiple shelves or attachment locations for tote 61 could be installedto support multiple totes 61 (FIG. 18); this may be desirable toaccommodate a large number of prescriptions to be filled for a givenpharmacy location and/or to accommodate prescriptions for more than oneremote pharmacy location 304, as discussed above.

Modifications to the system 40 may be made to facilitate this drop-offprocess such as the installation of a chute 63 (FIG. 18) or ramp toguide the movement of the vials into the tote 61 (FIG. 18). In oneembodiment, the chute(s) 63 may be illuminated. In another embodiment,the illumination of the chute(s) 63 may be accomplished using differentcolored and/or blinking lights, which may be used to indicate the statusof the location. An example of one such arrangement is as follows:

Chute light color/ state Indication Description/Example OFF System isidle System off or no tote in place at chute location GREEN Tote is OKTote is in place at that chute location and ready to receive vialsYELLOW Caution, The system is currently processing a vial in processvial that is destined for that chute/tote FLASHING Attention neededExemplary reasons: Tote is full; YELLOW barcode not readable FLASHINGFault/error/ Exemplary reasons: Tote is removed RED needs immediatewhile vial in process for that chute; attention tote overfilled; chutejammed

In one embodiment, the system 40 includes one or more sensors to detectthe presence or absence of a tote 61 in each location. In anotherembodiment, the system 40 includes one or more sensors to detect thelevel of the contents of each tote 61. In still another embodiment, thetote(s) 61 may be designated to hold filled prescriptions that areintended for pick up by patients at a later time (a different day, forexample) at the local pharmacy 302 and may be handled differently in thepharmacy's workflow than other prescriptions requiring earlierdistribution to patients, which may be dispensed through the offloadstation 66. The totes 61 and their contents can be designated for anypurpose that may make it desirable to segregate a group of filledprescriptions and, thereby, facilitate the workflow of the pharmacy.

In another embodiment, exemplified in FIG. 19, the system 40′ mayinclude an automatic bagger 67 to bag the prescription vials once thesystem 40′ has completed the filling process. The bagger 67 may bepositioned to facilitate receiving the filled prescription vial, such asfrom a chute 76, directly from the system 40′ so that the vial may beplaced in a bag prior to placement in the tote 61. One or more filledprescription vials may be placed in a bag; a prescription order for apatient may include more than one vial of medication filled in thesystem 40′ or may include items that must be retrieved from outside thesystem 40′, such as unit of use medications, tubes of ointment, slave,etc., oral contraceptives, prescription medications that must beretrieved from stock bottles, over the counter items, etc. The bag alsomay have one or more labels 69 with identifying information adhered toit; some nonlimiting examples of identifying information are patientname, patient address, patient phone number, prescription number, drugname, drug dosage, NDC number, drug image, drug description, remotepharmacy name, remote pharmacy identification number, remote pharmacyaddress, remote pharmacy phone number, etc. The identifying informationmay be alpha-numeric and/or encoded (e.g., barcode, RFID, etc.). Theidentifying information may be printed on the labels 69 or directly onthe bag by a printer that is associated with or integral to the bagger67, as shown in FIG. 19. Alternatively, labels 69 may be printed by aseparate printing unit and fed into the bagger 67 for application to thebags or may be otherwise applied to the bags. Exemplary bagging andlabel printing/applying systems may be obtained from Mark-Pack, Inc. ofCoopersville, Mich. (www.markpackinc.com). One of skill in the art willrecognize that the bagger 67 could be a table-top unit. Additionally,the bagger 67 may receive vials directly from the pharmaceuticaldispensing system 40′, as shown, or may be manually fed using vials thatare filled and separately offloaded from the pharmaceutical dispensingsystem 40′. Items that may be retrieved from outside the system 40′, asdiscussed above, may be manually fed into the bagger so that they can beincluded in a grouped order for a customer or, if the design of thesystem 40′ allows, may be dispensed from inside the system 40′ as well.Paper documentation also may be included in the bags, such as druginformation forms or insurance paperwork, which may be printed at aseparate printer or there may be a printer and automatic folding machineincluded as part of the bagging system and the papers may beautomatically added to the bags. Papers may be inserted in the bagsbefore they are closed or may be stapled to or otherwise attached to theoutside of the bag. Bags that are released from the bagger 67 may beloaded into a container, such as a tote 61; the container may be used asan interim collection container, may be designated for a particularstorage location in the hub pharmacy 302, or may hold bags which aredesignated for an off-site location, such as a remote pharmacy 304.

In a particular embodiment, the system graphical user interface (GUI)includes a portion specific to the filling of totes 61 to facilitateuser interaction with and monitoring of the system 40 during tote 61filling. Details of an exemplary GUI are set forth in U.S. PatentApplication Publication No. 2009/0287350, the disclosure of which ishereby incorporated by reference herein in its entirety. Referring nowto FIG. 14, in some embodiments the Home screen 200 the GUI may includean In Store Summary portion 202, where a high level status ofprescriptions entered into the system 40 for fulfillment is shown. TheHome screen 200 may include a Priority button 204 which allows the userto select whether the prescriptions for the local pharmacy 302 or theprescriptions entered for one or more remote pharmacies 304 are givenpriority in the filling process. A View button 206 allows the user toswitch between the view of the GUI for tote 61 filling and a view of theGUI for the local system 40, which includes the offload station 66, ifdesired. The GUI may include an Attached Totes display 208 showinginformation pertaining to those totes 61 currently associated with thesystem 40 for filling. The GUI may include a Removed Totes display 210,showing information pertaining to totes 61 currently not associated withthe system 40. Each of the Attached Totes 208 and Removed Totes 210displays may communicate information about the status of the totes 61such as the number of prescriptions in the tote 212, the designation ofthe store assigned to the tote 214, and the number of prescriptionsdirected to that tote 216. In one embodiment, the graphic for each tote61 includes a dynamic fill line 218 that moves higher on therepresentation of the tote 61 as vials are added to that tote 61 andserves as a graphic indicator of the fill status of that tote 61. Thedynamic fill level for each tote 61 may also include a color indicator.For example, the fill line for: a tote 61 that is full may be colored inred; a tote 61 that is near full (over a threshold level but not full)may be colored in yellow; and a tote 61 that under a threshold level maybe colored in green.

Turning now to FIG. 15, the GUI may include a Tote View screen 220 thatdisplays information specific to that tote 61 and, therefore, aparticular remote pharmacy 304. The Tote View screen 220 displays thedesignation of the store assigned to the tote 214. Such designation canbe indicated in any of various ways such as by number, name, color, logoor any other unique identifier, which also can be present on the tote61, in the form of alphanumeric text, RFID label, barcode, logo,graphics, etc. The Tote View 220 screen also comprises status tabs 222(Pending, Incomplete, Ready and Complete, for example) which include anindication of the number of prescriptions identified by that status. Theuser may select a status tab to view a list of prescriptions associatedwith this status and the details of each prescription.

The Tote View screen 220 may also include various buttons for differentfunctions or preferences related to the selected tote 61. Some of thesefunctions may include editing the settings associated with the tote(button 224), such as the store name, printing a barcode for the tote(button 225), or deleting a tote from the application (button 226). Itmay be desirable to fill the prescriptions for a given tote 61regardless of the status of the tote 61 (i.e., even if the sensorsindicate that the tote 61 is full or absent); the Force Filling button227 can be selected to perform this function. When all of theprescriptions for a given tote 61 have been filled (i.e., are in the“Ready” queue), the user can select the Pick Up All Scripts button 228which will move all of the prescriptions for that tote 61 into Completestatus in the system 40 (under local filling conditions, the bar codefor each prescription would have to be scanned individually to move thatprescription to Complete status in the system 40). The Tote View screen220 may also include a Priority button 229; in this case the selectionof priority will assign preference in the filling process to theprescriptions for the particular tote 61.

All of the locations for offload of filled prescription vials may bevisualized in the In-Store GUI screen 230, as exemplified in FIG. 16.The offload station 66 is represented graphically at 232 and 234. Thelocations labeled “B”, “C”, “D”, “E”, . . . , “T” 236 represent theindividual locations of the graphical representation 232 of the offloadstation 66. The locations of the other portion of the offload station 66can be displayed by scrolling through the other locations of section 232and 234. The totes 61 are represented by the Side Tote locations 238.

In some embodiments, it may be desirable to allow the system 40 tooperate unattended. In this way the system 40 still may be productivewhen the pharmacy is closed or otherwise slow, to maximize the volume ofprescriptions filled by the system 40 and/or for strategic use of system40 time. For example, when the pharmacy is closed or during slow periodswhen the pharmacy is open, the system 40 can fill prescriptions forlater retrieval by the pharmacy's own customers (i.e., refills,non-urgent prescriptions that customer indicates will be picked up atlater time). In another embodiment, the system 40 may operate to fillprescriptions for other pharmacy locations during theseslower/overnight/closed operational periods; these prescriptions wouldthen be delivered to the appropriate location once the orders arecomplete (hub and spoke arrangement).

In another embodiment, the imaging feature (discussed above) may beincluded in the system 40 during unattended operation. With the imagesavailable for all prescriptions filled during unattended operation, theimages for prescriptions contained in each tote 61 can be viewed by thepharmacist prior to releasing the tote 61 for delivery to the remotepharmacy 304. In some embodiments, the images for all prescriptionscontained in a tote 61 may be viewed by a remote pharmacist so that theremote pharmacist can provide verification that each prescription hasbeen filled correctly prior to release of the tote 61 and delivery tothe appropriate pharmacy. In some embodiments, the remote pharmacist mayreview the images for prescriptions filled by the system 40 to bedelivered to customers at the hub pharmacy 302; once the pharmacist hasverified that the prescription has been filled correctly, it may bereleased for delivery to the customer. For clarity, a “remotepharmacist” may be located anywhere other than with the system 40 at thehub pharmacy 302 and may or may not be located at one of the remotepharmacies 304. One of skill in the art will recognize that thefunctions described herein as being performed by a remote pharmacist mayalternatively be performed by a pharmacist located proximate to thesystem 40 (i.e., at the hub pharmacy 302). The system 40 may beconfigured to provide messages via text message, instant message, email,voice message, or any other form of message; these messages would bedelivered to pre-designated phone number(s) or email address(es) uponcertain situations that may arise, particularly during unattendedoperation of the system 40. Such messages may include indications of thefollowing:

-   -   System error (i.e., mechanical malfunction, system inoperable,        insufficient vial/label/cap/drug/bag inventory to complete a        prescription fill, etc.)    -   Power failure    -   Full tote(s)    -   Service needed    -   Low inventory in system (i.e., drugs, vials, caps, labels, bags)    -   Problems with prescription filling process (i.e., capping error,        labeling error, bagging error, etc.)    -   Prescription orders complete for delivery to specific remote        location        Messages may include specific instructions related to the        message, as may be programmed into the system 40. For example, a        message indicating that the prescription orders are complete for        a specific remote location 304 may include instructions to        schedule the delivery of the tote(s) 61 to the appropriate        remote location 304; this message may be sent directly to the        delivery organization as notification that the prescriptions are        ready for pick-up and delivery to the remote location 304. A        message indicating that one or more totes 61 is/are full may        include instructions to remove the tote(s) 61 and replace        it/them with an empty tote 61, possibly of a specific type        (i.e., a specific size and/or belonging to specific remote        location). A message indicating low inventory in the system 40        may include information regarding which locations of the tablet        dispensing station 62 need to be refilled and with which drug,        or that the vials or caps (of a specific size) need to be        refilled, etc. Messages indicating that the system 40 is        inoperable or that service is needed may be sent directly to a        repair person with a request for service on the system 40 and        may contain specific information on the type of service        required.

An exemplary process for filling prescriptions in a hub and spokepharmacy arrangement, as discussed above, is illustrated in FIG. 21. Asshown in FIG. 21, a patient's prescription is entered into the pharmacymanagement system of a remote pharmacy 304 and scheduled to be picked upat the same location (Block 400). For a prescription to be entered inthe system, the patient may drop off a paper prescription at the remotepharmacy 304, may request a refill (over the phone or in person), or mayplace an order electronically. Additionally, the prescription may beentered at the remote pharmacy 304 by a phone call or electronic orderfrom the ordering physician or by transfer from another pharmacy. Oncethe details of the prescription order are entered, the system querieswhether the prescription order meets criteria for filling of theprescription at the hub pharmacy 302 (Block 402). The criteria that areevaluated may include considerations such as pharmaceutical inventory atthe hub pharmacy 302, urgency of the prescription, scheduled pick-update/time, etc. If the criteria for fulfillment at the hub pharmacy 302are not met, the prescription is filled at the remote pharmacy 304(Block 404). If the criteria for fulfillment at the hub pharmacy 302 aremet, the prescription information is sent to the hub pharmacy 302 (Block406). The prescription may be received by a component of the hubpharmacy's pharmacy management system, a separate server, or the system40 itself. The prescription enters the queue of the system 40 (Block408), its location in the queue determined by criteria at the hubpharmacy 302; these criteria may include filling priority, theavailability of the appropriate drop-off location (tote 61), system 40inventory, delivery schedule for the tote 61, etc. The prescription isfilled (Box 410) by the steps illustrated in FIG. 1. The offloading ofthe filled, secured container (Box 38 of FIG. 1) is accomplished bydelivery of the prescription to the appropriate tote 61 for the remotepharmacy 304. The system 40 also may include a camera 72 to capture animage of the vial contents or a scale to obtain the weight of the vialand its contents, respectively, as discussed above. The next step in theprocess is verification by a pharmacist that the prescription has beenfilled as ordered (PV2) (Block 412). The PV2 step may be completed by apharmacist at the hub pharmacy 302; this process can be facilitated bythe pharmacist's review of the images of each prescription so that thepharmacist does not have to open each vial (this approach is aparticular advantage if the prescriptions are bagged prior to releaseinto the tote 61). Alternatively, automated image analysis of thecaptured images may be performed for the PV2 step, which also isadvantageous when the vials are bagged prior to release into the tote61. PV2 may be performed by a pharmacist at a remote location, whetherit be that of the remote pharmacy 304 from which the prescription wasreceived or another pharmacy different from the hub pharmacy 302; theimages of the filled prescriptions and the prescription information maybe sent electronically to another location where a pharmacist can viewthe available information and perform the verification of the filledprescription. An indication of the prescription's verification status,such as verified or rejected, may be indicated on the label or bag. Whenall prescriptions for a given remote pharmacy location 304 have beenfilled, the tote 61 is prepared and sent to the remote pharmacy 304(Block 414). Preparation of the tote 61 may include the preparation of amanifest or other documentation, which may include order identificationnumbers, item numbers, quantity, barcodes, etc., in addition to deliveryinformation or other information; information about the tote 61, itsdestination, contents, etc. may be in alphanumeric text, or may take theform of a unique code, which may be a bar code, RFID label, or othercode. The manifest or other documentation may be printed by choosing abutton on the GUI (not shown). Preparation of the tote 61 also mayinclude bagging of the filled prescriptions, if they have not alreadybeen bagged prior to release into the tote 61, as discussed above, orpackaging into a secondary type of package. Alternatively, theprescriptions may be placed in bags at the remote pharmacy 304, prior todistribution to the patient or patient representative picking up theprescription from the remote pharmacy 304. When the tote 61 is receivedby the remote pharmacy 304 (Block 416), the prescriptions aredistributed to the patient or their representative when they arrive forpick-up (Block 418). The filled prescriptions may be temporarily storedin a will call device or will call area of the remote pharmacy 304 toawait pick up.

The foregoing is illustrative of the present invention and is not to beconstrued as limiting thereof. Although exemplary embodiments of thisinvention have been described, those skilled in the art will readilyappreciate that many modifications are possible in the exemplaryembodiments without materially departing from the novel teachings andadvantages of this invention. For example, many types of error messages,specific message content, instructions and message delivery destinationsare possible and evident to one of skill in the art with the teachingsof this invention. As another example, the types of GUI screens,information displayed and functional buttons may be tailored tofacilitate the workflow of the pharmacy and the particular assignment oftotes (i.e., whether for delivery to a remote pharmacy, for in-storepatient pick-up, or other destination or categorization). Additionally,a variety of different light locations as well as different color andpattern combinations can be implemented to provide information regardingthe status of the system and specific totes or chutes. Whileprescriptions may be entered at a remote pharmacy and scheduled to bepicked up at the same pharmacy, the prescription can be scheduled to bepicked up at any pharmacy, without changing the teachings and advantagesof this invention. Prescriptions may be verified (PV2) manually by apharmacist at either the hub pharmacy or when they are received at theremote pharmacy, prior to delivery to the patient. Accordingly, all suchmodifications are intended to be included within the scope of thisinvention as defined in the claims. The invention is defined by thefollowing claims, with equivalents of the claims to be included therein.

That which is claimed is:
 1. An offloading unit for an automatedpharmaceutical machine that dispenses filled, capped pharmaceuticalvials, comprising: at least one offload location; at least one tote toreceive the vials at each offload location, the tote assigned fordistribution to a remote pharmacy location; at least one detectionsensor to detect the presence or absence of the tote; and at least onefill sensor to detect a fill level of the vials in the tote.
 2. Theoffloading unit of claim 1, wherein a chute guides the vials into thetote.
 3. The offloading unit of claim 2 wherein the chute is illuminatedwith at least one light.
 4. The offloading unit of claim 3 wherein theat least one light communicates the status of the offload location. 5.The offloading unit of claim 4 wherein the status of the offloadlocation is communicated by at least one of a color or an illuminationpattern of the at least one light.
 6. The offloading unit of claim 1wherein the at least one tote comprises a unique code.
 7. The offloadingunit of claim 6 wherein the unique code indicates at least one of:information about the vials loaded in the tote and information about theremote pharmacy location.
 8. A pharmaceutical dispensing system,comprising: a frame; a plurality of cells configured to housepharmaceutical pills; a processor; memory coupled to the processor; anda computer program residing in the memory that is executable by theprocessor for transmitting a message to one or more pre-identifiedrecipients about a status or function of the system.
 9. Thepharmaceutical dispensing system of claim 8 wherein the message isdelivered by at least one of text message, email message, instantmessage, or voice message.
 10. The pharmaceutical dispensing system ofclaim 8 wherein the message comprises information about at least one of:a system error; a power failure; a fill level of a tote; an inventorylevel; a prescription order status; a service requirement of the system;a problem encountered by the system while filling orders; instructionsfor responding to the message; and a service request.
 11. Thepharmaceutical dispensing system of claim 8 further comprising a camerafor capturing images of filled prescriptions.
 12. The pharmaceuticaldispensing system of claim 8 further comprising a bagger forautomatically bagging the filled prescriptions.
 13. The pharmaceuticaldispensing system of claim 11 further comprising a computer programresiding in the memory that is executable by the processor forautomatically analyzing the images captured by the camera.
 14. Thepharmaceutical dispensing system of claim 8 further comprising a weightsensor for determining a weight of a filled vial.
 15. A pharmaceuticaldispensing system, comprising: a frame; a plurality of cells configuredto house pharmaceutical pills; a processor; memory coupled to theprocessor; at least one offload location; at least one tote to receivethe vials at each offload location, the tote assigned for distributionto a remote pharmacy location; at least one detection sensor to detectthe presence or absence of the tote; at least one fill sensor to detecta fill level of the vials in the tote; and a GUI, wherein the GUIincludes a portion specific to filling of the at least one tote.
 16. Thepharmaceutical dispensing system of claim 15 wherein the GUIcommunicates information about a status of the totes.
 17. Thepharmaceutical dispensing system of claim 16 wherein the status is atleast one of: the association of the tote with the system, a number ofprescriptions in the tote, a designation of the pharmacy locationassigned to the tote, a number of prescriptions directed to the tote,and a fill level of the tote.
 18. The pharmaceutical dispensing systemof claim 17 wherein the fill level of the tote is indicated by at leastone of a dynamic fill line or a color.
 19. The pharmaceutical dispensingsystem of claim 15 further comprising a camera for capturing images offilled prescriptions.
 20. The pharmaceutical dispensing system of claim15 further comprising a bagger for automatically inserting the filledprescriptions into bags.
 21. The pharmaceutical dispensing system ofclaim 19 further comprising a computer program residing in the memorythat is executable by the processor for automatically analyzing theimages captured by the camera.
 22. The pharmaceutical dispensing systemof claim 20 wherein the bagger further comprises a printer for printingidentifying information on a label or on a bag.
 23. The pharmaceuticaldispensing system of claim 20 wherein documentation is added to one ormore of the bags.
 24. The pharmaceutical dispensing system of claim 15wherein in the portion of the GUI specific to filling of the at leastone tote allows a user to create a manifest for the at least one tote.